Senior Service Advocate

Medicare Individual Customer Service Representative

We're building a world of health around every individual shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger helping to simplify health care one person, one family and one community at a time.

The Medicare Individual Customer Service Representative serves as the Single Point of Contact for member service inquiries and requests received by telephone. The role supports Individual Medicare members by listening carefully, asking the right questions, and resolving issues through accurate research, documentation, and follow-through. This position uses multiple systems to consult, educate, and guide members based on their individual needs.

Key Responsibilities

• Handle inbound member calls and serve as the primary contact for service-related questions, issues, and requests
• Verify member information, gather details, and accurately document interactions and outcomes in required systems
• Research and resolve concerns by navigating multiple tools, policies, and resources to determine next best steps
• Educate members on benefits, coverage-related topics, and available resources using clear, respectful, plain language
• Support members who raise medical concerns by asking clarifying questions, following approved processes, and connecting them to the appropriate resources when needed
• Manage multiple tasks during and after calls (notes, follow-ups, case routing, and updates) while maintaining quality and productivity expectations
• De-escalate difficult calls by remaining calm, showing empathy, and working toward resolution and member satisfaction
• Meet or exceed performance standards related to quality, timeliness, and overall service experience
• Collaborate with internal partners as needed to resolve member issues and close the loop on commitments

Required Qualifications

• 1+ years of customer service experience
• Must reside in EST/CST time zone
• Ability to build trusting relationships by taking accountability to fully understand the member's needs
• Ability to multitask and handle multiple functions and/or multiple products while maintaining and/or exceeding performance standards
• Demonstrates professionalism and presents a positive image when interacting with members and constituents
• Demonstrates strong member focus and utilizes all available resources to ensure prompt member satisfaction
• Demonstrates functional expertise and leadership ability
• Strong communication skills

Preferred Qualifications

• Microsoft Office experience
• 1+ year of Medicare Service experience

Education

• High School or GED equivalent

Anticipated Weekly Hours: 40

Time Type: Full time

Pay Range: $18.50 - $35.29

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 09/15/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.